WELCOME 2010 - 2011 OSHA UPDATE BLOODBORNE PATHOGENS Nancy Allen, RN, BS, MPH, COHN-S, CCM/R EMPLOYEE HEALTH NURSE CONSULTANT TOPICS OSHA TERMS UPDATES HEPATITIS B HEPATITIS C HIV REPORTING AN EXPOSURE OBJECTIVES To have a basic understanding of blood borne pathogens and the role of OSHA To understand how to report an exposure To understand the role of the school nurse in an exposure. WHY? 1. IT IS AN OSHA FEDERAL REQUIREMENT 2. Through education and understanding,the employee will be protected and the risk of an exposure can be reduced. WHAT IS OSHA? OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (Started in 1970) SCHOOL DISTRICT’S EXPOSURE CONTROL PLAN (ECP) NEEDS TO BE BASED ON: 29 CFR 1910.1030 BLOODBORNE PATHOGENS STANDARD FEDERAL Register December 6, 1991 OSHA STANDARD ADDRESSES: RULES FOR PROTECTIING HEALTH AND SAFETY WORKERS FROM OCCUPATIONAL EXPOSURE TO BLOOD AND CERTAIN OTHER BODY FLUIDS POTENTIALLY CONTAINING BLOODBORNE PATHOGENS. BBP TRAINING IS MANDATORY UPON EMPLOYMENT FOR NEW HIRES AND ANNUALLY FOR ALL EMPLOYEES. BBP TRAINING INCLUDES: NEW HIRE EDUCATION AND TRAINING ANNUAL EDUCATION AND TRAINING AVAILABILITY OF PPE (Personal Protective Equipment) OFFERING OF HEPATITIS B TO AT RISK EMPLOYEES PROPER REPORTING OF NEEDLESTICKAND BLOOD/BODY FLUID EXPOSURES EXPOSURE CONTROL PLAN IS WRITTEN TO: MINIMIZE EXPOSURE TO BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS (OPIM) MANAGE EXPOSURES PROPERLY AND MEDICALLY DESCRIBE ENGINEERING AND WORK PRACTICE CONTROLS WHICH REDUCE RISK. SCHOOL NURSES AND MEDICAL SAFETY DEVICES IMPLEMENTATION OF SAFER NEEDLE/SYRINGE DEVICES IN SCHOOL DISTRICTS TO KEEP THE SCHOOL NURSE SAFE FROM BLOODBORNE PATHOGENS STANDARD PRECAUTIONS TREATALL BLOOD AND BODY FLUIDS AS IF THEY ARE KNOWN TO BE INFECTIOUS AT-RISK EMPLOYEES THOSE EMPLOYEES WHO, BY NATURE OF TASK, HAVE THE POTENTIAL TO BE EXPOSED TO BLOOD, BODY FLUIDS OR OTHER POTENTIALLY INFECTIOUS MATERIALS PPE – PERSONAL PROTECTIVE EQUIPMENT GLOVES MASKS EYE PROTECTION FACE SHIELDS RESPIRATORS GOWNS, APRONS, LAB COAT WORK PRACTICE CONTROLS HAND WASHING PROPER USE OF SHARPS CONTAINER – ¾ FULL STORAGE AND SHIPPING OF CONTAMINATED EQUIPMENT NO EATING, DRINKING, SMOKING, HANDLING CONTACT LENSES AND APPLYING MAKE-UP AT WORK AREAS ENGINEERING CONTROLS RESPIRATOR MEDICAL SAFETY DEVICES SHARPS CONTAINERS OPIM – OTHER POTENTIALLY INFECTIOUS MATERIAL ANY BODY FLUID THAT IS GROSSLY CONTAMINATED WITH BLOOD OR ANY INTERNAL BODY CAVITY FLUID SMALL WASTE GENERATORS Each School District is a small waste generator if they produce < 50 pounds/month. R.61-105, infectious Waste Management Act, Effective June 24, 2005 Some Districts may have agreement with local Health Department Transport Sharps containers in a box in car trunk Diapers, sanitary napkins, wound dressings in school setting are not infectious. Use appropriate PPE (OSHA) Regular trash. LATEX SENSITIVITY IN SCHOOLS School nurse should notify School District Staff about Latex Allergies. Non-latex products – Band – Aids, BP Equipment, resuscitative equipment Be aware of products with latex – balloons, rubber bands, Squishie balls, rubber toys, erasers HEPATITIS C VIRUS RISK FACTORS 3-4 MILLION CHRONIC CARRIERS IN USA (CDC) 36,000 NEW INFECTIONS ANNUALLY IN US 50,000-70,000 CASES ESTIMATED IN SOUTH CAROLINA WHAT IS HEPATITIS B? VIRAL INFECTION OF THE LIVER SYMPTOMS – NONE/MILD/SEVERE CHRONIC CARRIERS (5%) CAN DEVELOP CHRONIC LIVER DISEASE AND CAN INFECT OTHERS 95% SPONTANEOUS RESOLUTION INCUBATION PERIOD – AVERAGE 60-90 DAYS, RANGE 45-180 DAYS. HEPATITIS B VACCINE – PROVIDES IMMUNITY (3 vaccine series) WHAT IS HEPATITIS C? VIRAL INFECTION OF THE LIVER CAN LEAD TO CIRRHOSIS AND CANCER LEADING INDICATOR FOR LIVER TRANSPLANT FLU-LIKE SYMPTOMS OR NO SYMPTOMS INCUBATION PERIOD – AVERAGE 6-7 WEEKS. RANGE 2-26 WEEKS NO VACCINE AVAILABLE WHAT IS HIV/AIDS? HIV=VIRUS THAT CAUSES AIDS Human ImmunodeficiencyVirus that Destroys T Cells, which are necessary for Healthy Immune System. INCUBATION PERIOD: Conversion to HIV positive within 25 Days to 3 months. Rarely Longer Than 6 months Can be HIV POSITIVE but not have developed AIDS PEP (Post Exposure Prophylaxis) is available – Initiate as soon as possible!! Interval after which there is no benefit for humans is undefined. AIDS=ACQUIRED IMMUNODEFICIENCY SYNDROME 1/2 PEOPLE Who Are HIV positive DEVELOP AIDS WITHIN 10 YEARS HIV + Certain Chronic Disease/Destroyed T Cells=AIDS HEPATITIS B, HEPATITIS C & HIV Life-threatening BBP Transmitted through exposure to blood and other infectious body fluids Anyone with occupational exposure is at risk Workers must use PPE and engineering controls OCCUPATIONAL EXPOSURES: HCW (HCP) RESPONSIBIBILTIES KNOW BASIC BBP (HBV, HCV, HIV) ISSUES ATTEND ANNUAL BPP TRAINING KNOW WHAT IS A BONA FIDE EXPOSURE REPORT IT!!! PER SCHOOL DISTRICT POLICY IF YOU DON’T KNOW, ASK!!! IF YOU THINK YOU HAVE BEEN EXPOSED IMMEDIATELY TAKE CARE OF YOURSELF AND IMMEDIATELY NOTIFY THE APPROPRIATE PERSON IN YOUR SCHOOL DISTRICT DEPENDING ON THE EXPOSURE SCHOOL NURSE WILL IMMEDIATELY ASSIST THE EXPOSED PERSON WASH HANDS FLUSH EYES WITH WATER REMOVE ANY SOILED CLOTHING GET HELP FROM ANOTHER TRAINED FIRST RESPONDER DO NOT DELAY IN REPORTING PAPERWORK WILL BE DONE BY THE DESIGNATED PERSON IN YOUR SCHOOL DISTRICT. THIS MAY VARY FROM DISTRICT TO DISTRICT EACH SCHOOL DISTRICT IS RESPONSIBLE FOR DEVELOPING A POST EXPOSURE MANAGEMENT PROCEDURE THE SCHOOL NURSE MAY BE CONSULTED IN DEVELOPING THIS CDC BBP OEM/PEP Guidelines: Summary 1. Provide immediate care to the exposure site. Notify supervisor immediately!!!! 2. Evaluate risk of exposure (type of fluid, type of exposure) 3. Evaluate exposure source for BBP’s 4. Evaluate the exposed person 5. Give PEP (HIV, HBV) for exposures posing risk of infection transmission 6. Perform appropriate follow-up testing and provide counseling QUESTIONS??? To complete your update, please click link below to take the BBP Test. Please see your school nurse regarding the test.